Healthcare Provider Details

I. General information

NPI: 1417302233
Provider Name (Legal Business Name): MEGYN ROSE SEBESTA D.O.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: MEGYN ROSE BEYER DO

II. Dates (important events)

Enumeration Date: 04/29/2016
Last Update Date: 07/01/2026
Certification Date: 07/01/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

13123 E 16TH AVE
AURORA CO
80045-7106
US

IV. Provider business mailing address

PO BOX 110429
AURORA CO
80042-0429
US

V. Phone/Fax

Practice location:
  • Phone: 720-777-1234
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License NumberDR.00617763
License Number StateCO
# 2
Primary TaxonomyN
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number2019-00830
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: